Provider Demographics
NPI:1235443771
Name:KULASINGHE, TANUJA G (MD)
Entity Type:Individual
Prefix:MS
First Name:TANUJA
Middle Name:G
Last Name:KULASINGHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 12622
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4017
Mailing Address - Country:US
Mailing Address - Phone:443-481-6469
Mailing Address - Fax:443-481-6515
Practice Address - Street 1:2001 MEDICAL PARKWAY
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3280
Practice Address - Country:US
Practice Address - Phone:443-481-1750
Practice Address - Fax:443-481-1687
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2013-12-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD71094207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CSB4AA96760103OtherCAREFIRST MARYLAND
MD035916500Medicaid
607156012OtherDEPARTMENT OF LABOR
V8260036OtherCAREFIRST
CSB4AA96760103OtherCAREFIRST MARYLAND
607156012OtherDEPARTMENT OF LABOR